Methacrylated gelatin and platelet-rich plasma based hydrogels promote regeneration of critical-sized bone defects.

Physiological repair of large-sized bone defects requires instructive scaffolds with appropriate mechanical properties, biocompatibility, biodegradability, vasculogenic ability and osteo-inductivity. The objective of this study was to fabricate in situ injectable hydrogels using platelet-rich plasma (PRP)-loaded gelatin methacrylate (GM) and employ them for the regeneration of large-sized bone defects. We performed various biological assays as well as assessed the mechanical properties of GM@PRP hydrogels alongside evaluating the release kinetics of growth factors (GFs) from hydrogels. The GM@PRP hydrogels manifested sufficient mechanical properties to support the filling of the tissue defects. For biofunction assay, the GM@PRP hydrogels significantly improved cell migration and angiogenesis. Especially, transcriptome RNA sequencing of human umbilical vein endothelial cells and bone marrow-derived stem cells were performed to delineate vascularization and biomineralization abilities of GM@PRP hydrogels. The GM@PRP hydrogels were subcutaneously implanted in rats for up to 4 weeks for preliminary biocompatibility followed by their transplantation into a tibial defect model for up to 8 weeks in rats. Tibial defects treated with GM@PRP hydrogels manifested significant bone regeneration as well as angiogenesis, biomineralization, and collagen deposition. Based on the biocompatibility and biological function of GM@PRP hydrogels, a new strategy is provided for the regenerative repair of large-size bone defects.

Curculigoside attenuates osteoporosis through regulating DNMT1 mediated osteoblast activity.

This work aims to study the function of curculigoside in osteoporosis and explore whether DNMT1 is closely involved in osteoblast activity. After OB-6 osteoblasts were treated with hydrogen peroxide (H2O2), a curculigoside treatment group was set up and a series of biological tests including MTT, flow cytometry, western blotting, ROS fluorescence intensity, mitochondrial membrane potential, and ELISA experiments were performed to verify the effect of curculigoside on the activity of osteoblasts. Then, alkaline phosphatase (ALP) activity, alizarin red staining, PCR, and western blotting assays were performed to detect the effects of curculigoside on osteoblast function. By constructing DNMT1 knockdown and overexpression OB-6 cell lines, the effect of DNMT1 on osteoblast function was verified. In addition, the expression level of Nrf2 in each group was detected to speculate the mechanism of DNMT1 in osteoporosis. The cell activity and level of bcl-2 and SOD were significantly increased; the cell apoptosis, ROS fluorescence intensity, mitochondrial membrane potential, MDA and level of caspase-3, Bax, and CAT was reduced in curculigoside treatment group compared with H2O2-induced OB-6 osteoblasts. Meanwhile, the ALP activity, number and area of bone mineralized nodules, and gene and protein expression of OSX and OPG were significantly elevated in curculigoside group. Moreover, DNMT1 knockdown had a similar promotion effect on osteoblast function as curculigoside, and DNMT1 overexpression could reverse the promotion effect of curculigoside on osteoblast function. Further mechanistic studies speculated that DNMT1 might play a role in osteoporosis by affecting Nrf2 methylation. Curculigoside enhances osteoblast activity through DNMT1 controls of Nrf2 methylation.

Magnetic Resonance Imaging Manifestations of Annular Ligament Injuries in Children With Monteggia Fractures.

BACKGROUND: Magnetic resonance imaging (MRI) is commonly performed in children with elbow injuries to visualize soft tissues such as the annular ligament. Herein, we investigated the MRI manifestations of annular ligament injuries in children with Monteggia fractures following attempted closed reduction. METHODS: The clinical and imaging data of 88 children with acute Monteggia fractures treated at our hospital between 2015 and 2019 were analyzed. Clinically and radiographically, 67 patients achieved radiologic reduction of the radial head at the time of MRI, whereas 21 patients had a failed closed reduction. Annular ligament injury and superior radioulnar joint congruency were analyzed qualitatively, and the maximum superior radioulnar joint gap distance was measured. RESULTS: MRI manifestations of annular ligament injury were primarily characterized as varying degrees of annular ligament displacement, as follows: I degree (10 patients), the annular ligament encircled the radial head without displacement; II degree (5 patients), the annular ligament was partially displaced but visibly encircled the radial head at the level of the radial notch; and III degree (73 patients), the annular ligament was completely displaced. In 15 patients with I and II degrees annular ligament injuries, the annular ligament encircled the radial head (maximum superior radioulnar joint gap distance, 1.2±0.3 mm), showing good congruency of the superior radioulnar joint. In 73 patients with III degree annular ligament injury, the annular ligament was displaced and did not encircle the radial head (maximum superior radioulnar joint gap distance, 3.3±2.7 mm; P <0.05), showing good congruency of the superior radioulnar joint in 25 of 73 patients, and significantly poor congruency in 48 of 73 patients ( P <0.05). CONCLUSIONS: Annular ligament injuries in children with Monteggia fractures exhibit different degrees of displacement of the annular ligament. In I and II degree annular ligament injuries, the annular ligament still encircles the radial head. In III degree annular ligament injuries, the annular ligament is displaced away and is no longer around the radial head. Without the annular ligament restraining the radial head, the superior radioulnar joint is more likely to exhibit poor congruency and increased gap distance. LEVEL OF EVIDENCE: Level II.

Mariniradius sediminis sp. nov., a multi-xenobiotics degrading genes harbouring bacterium isolated from sediment of river.

A Gram-stain-negative, strictly aerobic, non-motile, catalase- and oxidase-positive, pink and rod-shaped strain, designated RY-2T, was isolated from sediment of Fuyang River located in Wuqiang County, Hengshui City, Hebei Province, PR China. The strain grew at 25-45 °C (optimum, 37 °C), pH 7.0-8.0 (optimum, pH 7.0) and in the presence of 0-1.5 % (w/v) NaCl (optimum, 1 %). From the phylogenetic analysis of the 16S rRNA gene sequence, strain RY-2T was affiliated to the genus Mariniradius, and had the highest 16S rRNA gene sequence similarity to Mariniradius saccharolyticus JCM 17389T (98.3 %) and the similarity values between strain RY-2T and other type strains was all below 89.3 %. The genome size of strain RY-2T was 4.75 Mb and the DNA G+C content was 46.6 %. Values of digital DNA-DNA hybridization and average nucleotide identity between strain RY-2T and the reference strain were 63.2 and 95.5 %, respectively. The major fatty acids (≥5.0 %) were iso-C15 : 0 (37.9 %), summed feature 9 (8.4 %, iso-C17 : 1 ω9c and/or C16 : 010-methyl), anteiso-C15 : 0 (8.2 %), iso-C17 : 0 3-OH (7.6 %) and summed feature 4 (5.2 %, iso-C17 : 1 I and/or anteiso-C17 : 1 B) and its sole menaquinone was MK-7. The polar lipids consisted of phosphatidylethanolamine, an unknown phosphoglycolipid, an unidentified phospholipid, two unidentified aminolipids, three unidentified glycolipids and nine unidentified lipids. Based on the results of biochemical, physiological, phylogenomic and chemotaxonomic analyses, strain RY-2T is considered to represent a novel species of the genus Mariniradius within the family Cyclobacteriaceae, for which the name Mariniradius sediminis sp. nov. is proposed. The type strain is RY-2T (=GDMCC 1.2781T=JCM 35631T).

A 12-Port MIMO Antenna System for 5G/WLAN Applications.

In this paper, a 12-port MIMO antenna system for 5G/WLAN applications is proposed. The proposed antenna system consists of two types of antenna modules: an L-shaped antenna module covering the C-band (3.4-3.6 GHz) for 5G mobile applications and a folded monopole module for the 5G/WLAN mobile application band (4.5-5.9 GHz). Each two antennas form a pair, six pairs in total, forming a 12 × 12 MIMO antenna array, and the elements between the antenna pairs can achieve an isolation of 11 dB or more without additional decoupling structures. Experimental results show that the antenna can cover the 3.3-3.6 GHz and 4.5-5.9 GHz bands with an overall efficiency greater than 75% and an envelope correlation coefficient less than 0.04. Finally, the one-hand holding mode and two-hand holding mode are discussed to demonstrate their stability in practical applications, and the results show that they still exhibit good radiation and MIMO performance when operating in both modes.

Combined approach versus single Henry approach for fixation of die-punch distal radius fractures: a retrospective study.

BACKGROUND: Distal radius fracture (DRF) is one of the most common orthopaedic-related traumas. DRF patients with die-punch fractures have a higher risk of loss of reduction, poorer functional outcomes, and increased risk of complications even after open reduction and internal fixation (ORIF). According to the three-column theory, the lunate fossa is an important part of the intermediate column for load bearing. When the distal radius fracture involves the lunate fossa, adequate anatomical reduction can have an important impact on the prognosis of wrist function. Herein, we used the combined volar and dorsal approach, and the dorsal approach was used to assist in bone grafting or dorsal plate fixation in reducing fractures. We compare the combined approach versus the Henry approach for the fixation of die-punch distal radius fractures. METHODS: We reviewed patients who were admitted for surgery for die-punch fractures from January 2016 to June 2021. The patients were followed-up after surgery to measure and evaluate their Gartland-Werley wrist score, wrist range of motion (ROM), and follow-up imaging data. RESULTS: There were 21 patients in the volar locking plate (VLP) group and 10 patients in the combined approach group. The majority of fractures in the VLP and combined approach groups were AO B and C fractures, respectively. The cause of injury and AO fracture classification showed significant differences between the two groups, and there was no difference in age or sex between the two groups. There was no significant difference in ROM between the two groups, but the VLP group presented a better Gartland-Werley score and volar tilt angle, and the combined group presented better maintenance in radial height and articular congruity. CONCLUSIONS: Reduction through the combined palmar and dorsal approach supplemented by bone grafting or dorsal plate fixation is an effective method for the treatment of die-punch distal radius fractures, which provides a new option for the treatment of die-punch fractures.

A Compact UWB Monopole Antenna with Triple Band Notches.

This article presents an ultra-wideband (UWB) monopole antenna with triple band notch characteristics. The proposed antenna consists of an octagonal patch, fed with a 50 Ω line, which occupies a compact size of 40 mm × 29 mm (0.36λ × 0.26λ, λ is computed using 2.7 GHz frequency) and resonances at a relatively low frequency (2.94 GHz). Specifically, an L-shaped stub, an inverted C-shaped slot, and a pair of U-shaped resonating structures are introduced into the design, which allow antenna to generate three band notches at 3.22-3.83 GHz, 4.49-5.05 GHz and 7.49-8.02 GHz, corresponding to WiMAX band, Indian national satellite (INSAT) band, and X-band satellite frequencies, respectively. In the center of the notched band, the antenna has lower efficiency and gain, essentially indicating that the antenna has good interference rejection performance. To evaluate its performance, the proposed antenna has been fabricated and measured, and the relevant functional parameters, such as S-parameters, voltage standing wave ratio (VSWR) and radiation property, have been studied.

Acute Spinal Epidural Abscess of the Cervical Spine Caused by Streptococcus constellatus Leads to Paraplegia in an Adult: A Case Report.

The incidence of a spinal epidural abscess (SEA), which can cause serious neurological complications, is low; however, the incidence of SEA caused by Streptococcus is even lower, most of which are reported in the thoracolumbar spine and lumbosacral segment. We reported a case of cervical SEA caused by Streptococcus constellatus infection, resulting in paralysis of the patient. The acute onset of SEA in a 44-year-old male led to decreased upper limb muscle strength, lower limb paralysis, and loss of bowel and bladder function, and imaging and blood tests suggested pyogenic spondylitis. Emergency decompression surgery and antibiotic therapy were given, the patient gradually recovered, and the muscle strength of the lower limbs gradually improved. This case report suggests the importance of early decompressive surgery and effective antibiotic therapy.

Flavihumibacter fluminis sp. nov., a novel thermotolerant bacterium isolated from river silt.

A yellow, Gram-stain-positive, strictly aerobic, thermotolerant, non-motile and rod-shaped bacterial strain, designated RY-1T, was isolated from a silt sample of Fuyang River, Wuqiang County, Hengshui City, Hebei Province, PR China. Cells showed oxidase- and catalase-positive activities. Growth occurred at 20-45 °C (optimum, 37 °C) and pH 6.0-8.0 (optimum, pH 7.0), and in the presence of 0-1.5 % (w/v) NaCl (optimum, 0%). A phylogenetic tree based on 16S rRNA gene sequences revealed that strain RY-1T formed a phylogenetic lineage with Flavihumibacter members within the family Chitinophagaceae. A comparison of 16S rRNA gene sequences showed that strain RY-1T was most closely related to Flavihumibacter cheonanensis WS16T (98.6 %), Flavihumibacter sediminis CJ663T (97.7 %) and Flavihumibacter solisilvae 3-3T (97.6 %). The genome size of strain RY-1T was 4.71 Mb, and the DNA G+C content was 44.3  %. The average nucleotide identity, digital DNA-DNA hybridization and average amino acid identity values between strain RY-1T and reference strains were all lower than the threshold values for species delineation. Strain RY-1T contained menaquinone-7 and iso-C15 : 0, iso-C17 : 0 3-OH and iso-C15 : 1G as the sole respiratory isoprenoid quinone and major cellular fatty acids (≥5 %), respectively. The major polar lipids consisted of phosphatidylethanolamine, three unidentified aminolipids and four unidentified lipids. According to the results of phenotypic, phylogenetic and chemotaxonomic characteristics, strain RY-1T represents a novel species of the genus Flavihumibacter, for which the name Flavihumibacter fluminis sp. nov. is proposed. The type strain is RY-1T (=GDMCC 1.2775T=JCM 34870T).

Flavobacterium potami sp. nov., a multi-metal resistance genes harbouring bacterium isolated from shallow river silt.

Environmental pollution by heavy metals is becoming an increasing problem and has become a matter of great concern due to the adverse effects worldwide. In this study, we report a novel strain of multi-metal resistant bacteria. A Gram-stain-negative, strictly aerobic, non-motile, yellow, rod-shaped strain 17AT, was isolated from the shallow silt of Fuyang River located in Longdian town, Hengshui city, Hebei province, China. Strain 17AT grew at 20-35 °C (optimum, 30 °C), pH 5-10 (optimum, pH 7) and 0-2% (w/v) NaCl (optimum, 1%). Phylogenetic analyses of 16S rRNA gene sequences showed that strain 17AT was closely related to members of the genus Flavobacterium, and had the highest 16S rRNA gene sequence similarity with 'Flavobacterium panacis' DCY106T (97.5%), followed by Flavobacterium johnsoniae subsp. johnsoniae UW101T (97.3%), Flavobacterium cutihirudinis E89T (97.2%), Flavobacterium limi THG-AG6.4T (97.2%), Flavobacterium hibisci THG-HG1.4T (97.2%) and Flavobacterium johnsoniae subsp. aurantiacum DSM 6792T (97.1%). The genome size of strain 17AT was 5.4 Mb and the DNA G + C content was 34.0%. The average nucleotide identity, digital DNA-DNA hybridization and average amino acid identity values among strain 17AT and reference strains were in the ranges of 79.8-86.1%, 24.1-31.4% and 80.5-88.6%, respectively, lower than the threshold values for species delineation. Strain 17AT contained iso-C15:0 and C16:0 3-OH as the predominant fatty acids (≥ 10%). The main isoprenoid quinone of strain 17AT was identified as MK-6. The polar lipids consisted of phosphatidylethanolamine, three unidentified aminolipids, two unidentified aminophospholipids and six unidentified lipids. Comparative genomics analysis between strain 17AT and its reference type strains revealed that there are a number of metal-resistant genes in strain 17AT, which are located in 15 gene clusters responsible for the copper homeostasis, cobalt-zinc-cadmium resistance, copper resistance, and arsenic/antimony resistance, with the copper resistance protein NlpE being unique to 17AT. Combined data from phenotypic, phylogenetic and chemotaxonomic studies demonstrated that strain 17AT is a representative of a novel species within the genus Flavobacterium, for which the name Flavobacterium potami sp. nov. is proposed. The type strain is 17AT (= GDMCC 1.2723T = JCM 34833T).

BMP-2 promotes fracture healing by facilitating osteoblast differentiation and bone defect osteogenesis.

OBJECTIVE: To investigate the role of bone morphogenetic protein-2 (BMP-2) in promoting fracture healing in animal models. METHODS: Mouse models with muscle bag heterotopic osteogenesis (HO) were divided into a HO control group (not implanted with 250 µg rhBMP-2 bone repairing material), and a HO observation group (implanted with 250 µg rhBMP-2 bone repairing material); while rat models with bone defect (BD) were divided into a BD control group (not implanted with 250 µg rhBMP-2 bone repairing material) and a BD observation group (implanted with 250 µg rhBMP-2 bone repairing material). At 4 weeks after HO establishment, the new bone formation at the operation site was observed through visual inspections and X-ray scanning. The content of serum alkaline phosphatase (ALP) was detected by automatic biochemical analyzer. The formation of new bone at the operative sites was observed by Hematoxylin and eosin staining and Masson staining. At 0, 2, 4 and 8 weeks after operation, the growth of the defect area and its surrounding callus were observed by X-ray scanning. At 4 and 8 weeks after bone defect establishment in the mouse models, the histological changes and osteogenesis of the bone defect site were observed. RESULTS: The heterotopic osteogenesis experiment showed that at 4 weeks after operation, the mass at the muscle bag in the HO observation group became larger in contrast to the HO control group. X-ray scanning showed that there was obvious irregular bone shadow at the back muscle bag of mice from the HO observation group. The content of serum ALP in the HO observation group was significantly higher than that in the HO control group (all P<0.05). The muscle pocket in the HO observation group showed higher ectopic osteogenic activity comparing with the HO control group. Histological staining showed that bone tissue structure was visible in the newly regenerated bone, forming bone trabeculae and bone marrow tissue. Under the microscope, a large number of osteoblasts arranged neatly in a cubic shape presented at the edge of the new bone, and there were bone lacunae formed, and the bone tissue was in a relatively mature stage. In the rat bone defect models, X-ray scanning showed that the high-density development area was further increased. There was a large amount of callus formation in the bone defect area of the BD observation group, while the BD control group still had no high-density development. At 8 weeks after operation, the high-density development area decreased, indicating that there was partial absorption of callus, while there was still no high-density development in the BD control group. The callus of the bone defect area in the BD observation group was reduced and the defect area was gradually repaired, while the bone defect in the BD control group was still obvious and the bone repair was not completed. CONCLUSIONS: BMP-2 could promote osteoblast differentiation and bone defect osteogenesis in vivo. Thus, it is worthy of clinical application.

Electrophysiological, biomechanical, and finite element analysis study of sacral nerve injury caused by sacral fracture.

Background: We aimed to study the mechanism of sacral nerve injury caused by sacral fractures and the relationship between nerve decompression and nerve function. Methods: First, we observed the anatomical features of lumbosacral nerve root region in Sprague-Dawley rats. Next, the rats were divided into the sham, 10 g, 30 g, and 60 g groups for electrophysiological studies on nerve root constriction injury. Then we studied the biomechanical properties of rat nerve roots, lumbosacral trunk, and sacrum. Finally, we established a finite element analysis model of sacral nerve roots injury in rats and determined the correlation between sacral deformation and the degree of sacral nerve roots injury. Result: Anatomical study showed L5 constitutes sciatic nerve, the length of the L5 nerve root is 3.67 ± 0.15 mm, which is suitable for electrophysiological research on nerve root compression injury. After a series of electrophysiological study of L5 nerve roots, our results showed that nerve root function was almost unaffected at a low degree of compression (10 g). Nerve root function loss began at 30 g compression, and was severe at 60 g compression. The degree of neurological loss was therefore positively correlated with the degree of compression. Combining biomechanical testing of the lumbosacral nerve roots, finite element analysis and neuroelectrophysiological research, we concluded when the sacral foramina deformation is >22.94%, the sacral nerves lose function. When the compression exceeds 33.16%, early recovery of nerve function is difficult even after decompression. Conclusion: In this study, we found that the neurological loss was positively correlated with the degree of compression. After early decompression, nerve root function recovery is possible after moderate compression; however, in severe compression group, the nerve function would not recover. Furthermore, FEA was used to simulate nerve compression during sacral fracture, as well as calculate force loading on nerve with different deformation rates. The relationship between sacral fractures and neurological loss can be analyzed in combination with neurophysiological test results.

Lysobacter selenitireducens sp. nov., isolated from river sediment.

A Gram-stain-negative, yellow-pigmented, motile, flagellated and rod-shaped bacterium, designated as 13AT, was isolated from a river sediment sample of Fuyang River in Hengshui City, Hebei Province, PR China. Strain 13AT grew at 10-37 °C (optimum, 30 °C), at pH 5.0-11.0 (optimum, pH 7.0) and at 0-7 % (w/v) NaCl concentration (optimum, 0 %). Phylogenetic analysis based on the 16S rRNA gene sequence showed that strain 13AT belongs to the genus Lysobacter, and was most closely related to Lysobacter spongiicola DSM 21749T (97.8 %), Lysobacter concretionis DSM 16239T (97.5 %), Lysobacter daejeonensis GIM 1.690T (97.3 %) and Lysobacter arseniciresistens CGMCC 1.10752T (96.9 %). Meanwhile, the type species Lysobacter enzymogenes ATCC 29487T was selected as a reference strain (95.2 %). The genomic size of strain 13AT was 3.0 Mb and the DNA G+C content was 69.0 %. The average nucleotide identity values between strain 13AT and each of the reference type strains L. spongiicola DSM 21749T, L. concretionis DSM 16239T, L. daejeonensis GIM 1.690T, L. arseniciresistens CGMCC 1.10752T and L. enzymogenes ATCC 29487T were 75.9, 76.1, 77.7, 78.0 and 73.2 %, respectively. The digital DNA-DNA hybridization values between strain 13AT and each of the reference type strains were 21.7, 22.2, 21.9, 22.7 and 23.2 %, respectively. The average amino acid identity values between strain 13AT and each of the reference type strains were 72.5, 72.9, 72.3, 75.0 and 69.2 %, respectively. The major fatty acids were iso-C15 : 0, iso-C16 : 0 and summed feature 9 (iso-C17 : 1 ω9c and/or C16 : 0 10-methyl). The sole respiratory quinone was identified as ubiquinone-8. The polar lipid profile contained phosphatidylglycerol, diphosphatidylglycerol, phosphatidylethanolamine, an unidentified aminolipid, an unidentified lipid, four unidentified phospholipids and two unidentified glycolipids. Based on the phenotypic, physiological, phylogenetic and chemotaxonomic data, strain 13AT represents a novel species of the genus Lysobacter, for which the name Lysobacter selenitireducens sp. nov. is proposed. The type strain is 13AT (=JCM 34786T=GDMCC 1.2722T).

High cholesterol and low triglycerides are associated with total lumbar bone mineral density among adults aged 50 years and over: The NHANES 2017-2020.

Background: The association between cholesterol and triglycerides with the lumbar bone mineral density (BMD) was widely investigated, but the results remained conflicting. This study aimed to investigate the relationship between total cholesterol, triglycerides, and total lumbar BMD in adults. Materials and methods: This cross-sectional study included 1,985 individuals aged 50 years and over. The data on total cholesterol, triglycerides, total lumbar BMD, and other covariates were obtained from the National Health and Nutritional (NHANES) between 2017 and March 2020 pre-pandemic. Multivariate logistic regression models were utilized to investigate the association between cholesterol, triglycerides, and total lumbar BMD. Smooth curve fittings and generalized additive models were also used to analyze the potential non-linearity. Results: A total of 901 men and 1,084 women with a mean age of 63.02 ± 8.72 years (age 50-80 years) were included in this study. In multivariate regression analysis, the association between cholesterol and total lumbar BMD was negative (ß = -0.026, 95% CI: -0.033, -0.020). This relationship still existed after adjusted for gender and race (ß = -0.018, 95% CI: -0.025, -0.012) and fully adjusted for all covariates (ß = -0.022, 95% CI: -0.029, -0.015). The association between triglycerides and total lumbar BMD was positive (ß = 0.024, 95% CI: 0.017, 0.031). This relationship still existed after adjusted for gender and race (ß = 0.021, 95% CI: 0.015, 0.028) and fully adjusted for all covariates (ß = 0.021, 95% CI: 0.014, 0.028). In threshold effect analysis, the relationship between triglycerides and total lumbar BMD was an inverted U-shaped curve with the inflection point at 2.597 mmol/L. Conclusion: High levels of total cholesterol and relatively low levels of triglycerides are significantly associated with the total lumbar BMD in adults aged 50 years and over.

A combination of the K-L and S-P approaches for treating acetabular posterior wall factures accompanied by femoral head fractures with open reduction and internal fixation.

BACKGROUND: In clinical practice, acetabular posterior wall fracture combined with femoral head fracture is rare. However, with the increasing number of engineering and traffic accidents, such fractures, have increased significantly in recent years. This paper aims to explore the clinical efficiency of the Kocher-Langenbeck (K-L) and Smith-Petersen (S-P) combined approaches for open reduction and internal fixation (ORIF) of acetabular posterior wall fractures accompanied by femoral head fractures (Pipkin type IV fractures). METHODS: A retrospective study was conducted on 8 patients who underwent open reduction and internal fixation (ORIF) of Pipkin type IV fractures through the K-L combined with S-P approach in our hospital from January 2015 to January 2020. All 8 patients were successfully operated on without serious complications, such as important blood vessel and nerve damage, with an operation time of 143.8 ± 44.38 min and intraoperative blood loss of 225 ± 70.71 ml. Perioperative data were recorded. The Harris score was used to evaluate the clinical effect. Fracture reduction quality was evaluated according to the Matta radiological standard. The grade of ectopic ossification was evaluated by the Brooker grading method, and the stage of femoral head necrosis was evaluated by Ficat-Arlet staging. RESULTS: The Harris score increased significantly from 57.38 ± 4.779 at 3 months, to 76.13 ± 3.682 at 6 months, 88.25 ± 3.495 at 12 months, and 92.13 ± 2.232 at 36 months postoperatively. After statistical analysis, compared with the previous observation time point, the data comparison differences between the groups were statistically significant. P < 0.001, P < 0.001, P < 0.05). By the time of the latest follow-up, 6 of the 8 patients had recovered to the level of pre-injury sports capacity. In contrast, the other 2 patients remained below the level of pre-injury sports capacity. In terms of imaging evaluation, the quality of fracture reduction on radiographs was graded as excellent in 6 patients and good in 2 patients according to Matta's criteria. At the last follow-up, no heterotopic ossification or femoral head necrosis was found in of all the images. In addition, the hip joint space was normal in 6 cases, mildly narrowed in 1 case, and clearly narrowed in 1 case. CONCLUSIONS: The K-L combined with S-P approach provides effective exposure for the reduction and fixation of Pipkin type IV fractures and achieves satisfactory clinical outcomes.

Role of the proximal tibiofibular joint on the biomechanics of the knee joint: A three-dimensional finite element analysis.

PURPOSE: The proximal tibiofibular joint (PTFJ) is easily ignored, although many diseases of the knee are caused by PTFJ injuries. Therefore, studying PTFJ biomechanics is very important. The effects of PTFJ injury on ankle function have been reported. However, few studies have assessed the effects of PTFJ injury on the knee joint. This study was performed to describe the biomechanical effects of PTFJ on the knee joint according to a three-dimensional finite element model. METHODS: The knee joint of a healthy volunteer was scanned by CT and MRI. CT and MRI scanning data in DICOM format were imported into Mimics software. Subsequently, 3D models of the normal and PTFJ injured knee, including the bone, cartilage, meniscus and ligament structures were established, and their validity was verified on the basis of available studies in literature. The biomechanical changes in the two knee models under different conditions were compared. RESULTS: The validity of the intact model was verified. No significant difference was observed in tibial mobility in the two models under the conditions of 134 N forward, 10 N·m internal rotation and 10 N·m valgus load. After application of 134 N backward, 10 N·m varus and external rotation load with respect to the tibia, the posterior movement of the tibia and the varus and external rotation angles of the tibia were 3.583±0.892 mm, 4.799±0.092° and 18.963±0.027° in the normal knee model, and 5.127±1.224 mm, 5.277±0.104° and 21.399±0.031° in the PTFJ injury model, respectively, and a significant statistical difference was observed. CONCLUSIONS: PTFJ played an important role in maintaining the posterolateral stability of the knee joint and thus deserves more attention in clinical operations.

Flavobacterium selenitireducens sp. nov., isolated from rhizosphere soil of ancient mulberry.

A Gram-stain-negative, non-motile, aerobic, yellow, convex, rod-shaped mesophilic bacterial strain, designated strain D33T, was isolated from rhizosphere soil of ancient mulberry in Dezhou city, Shandong province, PR China. The strain grew at 8-37 °C (optimum, 30 °C), pH 4-9 (optimum, pH 7) and growth occurred at 0.5-5.5 % (w/v) NaCl (optimally at 1 %). The results of the phylogenetic analyses of 16S rRNA gene and whole genome sequences indicated that D33T was closely related to members of the genus Flavobacterium and had the highest 16S rRNA gene sequence similarity with 'Flavobacterium agri' KACC 19300 (95.4 %), Flavobacterium ichthyis NST-5T (94.6 %), Flavobacterium ahnfeltiae KCTC 32467T (93.6 %) and Flavobacterium longum JCM 19141T (93.6 %). The genome size of D33T was 3.8 Mb and the DNA G+C content was 48.0 mol%. The average nucleotide identity (ANI), digital DNA-DNA hybridization (dDDH) and average amino acid identity (AAI) values among D33T and reference strains were lower than the threshold values for species delineation. The only respiratory quinone of D33T was menaquinone 6 (MK-6). The predominant fatty acids (>5 %) were C15:0, C16 : 0, C18 : 0, iso-C15:0, iso-C17 : 0 3-OH, anteiso-C15 : 0 and summed feature 9 . The polar lipid profile contained phosphatidylethanolamine, two unidentified aminophospholipids, three unidentified aminolipids and two unidentified lipids. Combined data from phenotypic, phylogenetic and chemotaxonomic studies indicated that D33T is a representative of a novel species of the genus Flavobacterium, for which the name Flavobacterium selenitireducens sp. nov. is proposed. The type strain is D33T (=GDMCC 1.1946T=KACC 22131T).

Three-dimensional digital anatomical measurement of modified sacroiliac screws.

PURPOSE: To rebuild a model of the pelvis and effectively simulate the trajectory of modified sacroiliac screws, we measured the parameters of each screw and screw channel and assessed the safety and feasibility of the parameters in adults. METHOD AND MATERIALS: One hundred (50 males and 50 females) normal adult pelvic computed tomography (CT) images were randomly selected and imported into Mimics software to rebuild the three-dimensional pelvis model. In these models, each ideal channel of modified screws was simulated, and then we obtained the precise parameters of screws and channels using Mimics and Three-matic software. RESULTS: The results of the comparison (right vs. left) showed that there were no significant differences in any of the angles, radius or M1SI parameters (the first modified sacroiliac). However, one parameter (BS) of M2SI (the second modified sacroiliac), two parameters (AP and BS) of M3SI (the third modified sacroiliac), and three parameters (AP, BS, L) of M4SI (the fourth modified sacroiliac) were statistically significant (P < 0.05). The result of comparison (between genders) showed that there were no significant differences in M1SI and M2SI; in contrast, the radius, length and the α angle of M3SI and M4SI were significantly different between genders (P < 0.05), and the radius of M4SI required special attention. If the radius of the limiting screw channel was > 3.50 mm, 52 cases (52%, 24 males and 28 females) could not complete the M4SI screw placement among 100 samples. If the radius of the limiting screw channel was > 3.0 mm, a total of 10 cases (10%, 2 males and 8 females) could not complete the M4SI screw placement. CONCLUSION: Through the measurement of 100 healthy adult real three-dimensional pelvic models, we obtained the parameters of each modified sacroiliac screw and measured the three angles of each screw based on international coordinates for the first time, which can instruct clinical application.

Finite element analysis of infra-acetabular screw fixation for the treatment of acetabular posterior column fracture.

BACKGROUND: Infra-acetabular screws have been described to increase the fixation strength of acetabular fractures with separation of the columns. Previous studies were based on the simulation of the anterior column fractures without modelling the biomechanical effect of the screw in the posterior column fractures. The purpose of this study was to compare the stability of different internal fixation models of posterior column fracture and to provide a theoretical basis for the clinical application of infra-acetabular screws. METHODS: Five internal fixation models of acetabular posterior column fracture were simulated using five implants, including one reconstruction plate (PCP model), one posterior column screw (PCS model), one infra-acetabular screw (PIS model), one infra-acetabular screw and one reconstruction plate (PIS + PCP model), and one infra-acetabular screw and one posterior column screw (PIS + PCS model). After meshing, material parameter, and boundary condition settings, a vertical downward load of 500 N was applied on the surface of the sacrum. To evaluate the biomechanical properties, the stress distribution and von Mises peak stress were recorded and analyzed, and the displacement distributions of the upper and lower fracture surfaces were compared. RESULTS: In model PCP, the maximum stress of the plate is 71.952 MPa; in model PCS, the maximum stress of the screw is 52.740 MPa; in model PIS, the maximum stress of the screw is 68.985 MPa; in model PIS + PCP, the maximum stress of the plate is 64.695 MPa and the maximum stress of the screw is 39.679 MPa; and in model PIS + PCS, the maximum stress of the posterior column screw is 48.197 MPa and the maximum stress of the infra-acetabular screw is 65.201 MPa. The maximum stresses of implants are all located on the fracture surfaces. The average displacement differences of the upper and lower fracture surfaces are compared as follows: model PIS + PCS (0.03503 mm) < model PIS + PCP (0.08205 mm) < model PCP (0.10096 mm) < model PCS (0.19007 mm) < model PIS (0.23546 mm). CONCLUSION: With sufficient biomechanical stability, infra-acetabular screws can be used as a supplementary fixation for the treatment of acetabular posterior column fractures. It is recommended to fix the fracture by the combined application of the infra-acetabular screw and posterior column screw.

The largest secure corridor of the infra-acetabular screw-a 3-D axial perspective analysis.

BACKGROUND: The infra-acetabular screw which is placed from the pubis to the ischium can be used as a special positional screw of the posterior column of the acetabulum. This study was performed to simulate the surgical procedure and obtain the ideal insertion point, diameter, length and angle of the screw through the method of axial perspective in Chinese patients. METHODS: We randomly collected the pelvic computed tomography (CT) scans of 200 adults. DICOM-formatted CT-scan images were imported into Mimics software to establish the 3D digital model of the right semi-pelvic was established. A virtual cylinder representing the screw was placed from the pubis to the ischium to fix the posterior column. The largest secure diameter and length of the virtual screw were measured and the position of the insertion point and the directions of the screw were also researched. RESULTS: The screw insertion safe zone exhibits an irregular shape of "tear drop" in the reconstructed pelvic model. The mean maximum diameter of screws was 5.01 ± 1.28 mm, and the mean maximum length of screws was 93.99 ± 8.92 mm. The screw insertion corridor with the least diameter 3.5 mm was found in 94 of 100 males (94%) and 86 of 100 females (86%). We found gender-dependent differences for the mean maximum diameter and the maximum length of the screw. There was statistically significant difference between genders in the position of insertion point. CONCLUSIONS: In this study, we suggest an individual preoperative 3D reconstruction simulation to develop better screw placement plans, which provides a valuable guideline for seeking the largest secure corridor of infra-acetabular screw. Further biomechanical studies are needed to verify the function of the screw.